(This post originally appeared on The Hill)
I think some sort of a universal health care system (or “Medicare for All”) would be good for this country. A health care system where there are no premiums, no copays and no deductibles would be nice. Particularly so if it includes coverage for everything, including prescription drugs. So, if you’re a believer in that – and who wouldn’t be? – then you can’t get a better option than Sen. Elizabeth Warren‘s (D-Mass.) health care plan. That’s particularly so if you’re a small business owner.
Think about it. If you’re running a small business, health care is a major headache. It’s an enormous cost. It sucks up resources and administrative time. It’s intrusive — why should a small business owner even be aware of their employees’ (or their families’) health care issues as long as it doesn’t affect their job performance? The sad fact is that they are because these kinds of things usually affect their company’s health insurance premiums. They don’t need the headaches.
The good news is that Warren’s plan does away with all of these problems, and guess what? Her plan even makes the health care costs cheaper for a small business than what they’re paying today!
That’s right. Her plan would make business pay 98 percent of its current health care premiums not to a health insurance provider (they would no longer exist) but to the government. The smallest businesses that have provided no health insurance would continue to pay nothing.
Meanwhile all employees, whether they work for a small business or a big company, would be entitled to the same health care coverage. That would level the playing field for a small business trying to compete for talent against deep-pocketed corporations and the government. The cherry on top is that overhead would be reduced because there would no longer be a need for human resources people to administer a health care plan.
Win. Win. Win. Right? Well, hold on. Unfortunately, there’s scant research or surveys yet from small business owners about this topic. But I’ve been getting a much different response from the thousands of them that I meet each year in the course of my work.
Most – and I report this anecdotally – don’t like it. Why?
Is it the estimated $20-$34 trillion the government would need over 10 years to pay for it, according to a recent NPR interview with New York Times health care expert Sarah Kliff? Is it the lower pay that doctors would receive under her plan, which would drive them out of the profession and create a disincentive for many technology companies to innovate new products? Is it the millions of people who would potentially be out of work once administrators, brokers, hospitals and other organizations dependent on the current health care infrastructure are rendered useless or cannot sustain the new model? Is it the long wait times for medical procedures like our British and Canadian friends complain about?
It’s all of these things. But believe it or not, none of them individually is the main reason.
The main reason I hear from business owners is this: Disbelief. Disbelief that such a change could happen in a country as large as the U.S. Disbelief that the government could run a health care system more effectively than the private sector. Disbelief at the bureaucracy it would cause and at the loss of competition that would ensue. Disbelief in a politician’s promises.
But more importantly, disbelief that such an enormous, staggering, colossal bet – a bet that at $35 trillion is seven times the size of what our current government spends – would even be considered in light of all the uncertainties, doubts, fears and suspicions raised by so many about such a vast and potentially cataclysmic change.
Are they being unreasonable? Difficult? Obstinate? Perhaps.
But there is logic to this position. It’s because no successful business owner I know would take this kind of chance, given the immense costs and the risks involved. Small business owners don’t make gigantic bets like this on sketchy data. Which is why even though we all want a better health care system, very few business owners I meet are taking Warren’s solution seriously.